Doulas Help Low-Income Women in Surprising Ways

Doulas are trained professionals who can help you make the transition from pregnancy to motherhood. As it turns out, using one has some benefits for low-income moms.

Doulas Help Low Income Women in Surprising Ways Lapolo/Shutterstock

A recent study conducted at the University of Minnesota found that for one group, using a doula can provide unexpected benefits. Low income women may experience fewer instances of preterm birth and costly birth complications if they opt for a doula's services, according to the research.

Because doulas support the women they care for before, during and after birth, those who used doula care lowered their odds of preterm birth by 22 percent and decreased the risk of C-section by 56 percent.

"In previous studies, it is unclear if good outcomes happen because of doula support or rather the particular types of women wanting doulas and having a preference for 'natural' childbirth. The survey we used asked women if they wanted doula support but didn't have it, so we were able to account for this," said Katy Kozhimannil, Ph.D., the lead author of the study, published in the American Journal of Managed Care. "Our findings showed doula support during labor and birth, not the desire for doula support, is associated with 80 percent lower odds of non-indicated cesarean in comparison to non-supported births."

An underused resource

The study also pointed out that just 6 percent of women studied reported doula care during birth—and 40 percent were not even aware of doula care.

Minnesota resident Martha Auqualla opened up to CBS about her experience with a doula and it appears that doulas can help not only with the actual labor, but also by helping women implement smarter lifestyle choices during pregnancy.

"They help me a lot," Auqualla. "She tells me how you eat when you're pregnant, because you need to eat healthy."

But while reduced rates of birth complications is a major benefit to using a doula, the upsides exist after delivery as well. Auqualla also said that her doula has helped her with breastfeeding, which can be notoriously difficult for new moms.

Liz Abbene, who has been a doula for nine years weighed in on the benefits of using a doula to CBS. "There have been doula studies happening all over the world for a number of years, and every single one shows these benefits," she said. We have previously reported on the benefits of using a doula, the cost associated with doula care and the things doulas can help pregnant women understand.

Affording a doula

The wide-ranging benefits of using a doula have inspired Kozhimannil to call for insurance companies to consider covering the cost for women. "While average fees for doula care vary widely, most are around $1,000. With an approximate $10,000 mean difference between the cost of vaginal and cesarean delivery, the decision to cover 10 doula-supported births would be cost neutral if one non-indicated cesarean was avoided," she said. "Even setting aside other crucially important emotional, psychosocial, and longer-term benefits of doula-supported care, the financial rationale is compelling."

While Minnesota has a law that requires Medicaid to pay for doulas for low-income patients, a doula's services can be affordable for women all over the country who don't have access to the service on insurance. Check out Doulas Care or the IRS's listing of nonprofit doula organizations to find an affordable doula in your area.

Fit Pregnancy also spoke with doula society DONA to gain a bit more insight into the ways in which low-income women can afford doula care. "DONA International's vision—a doula for everyone who wants one—upholds that all families who desire a birth or postpartum doula should have access to that level of support," a representative from DONA said. "In keeping with this vision, many doulas who are certified through DONA International strive to find creative ways to work with women who are otherwise unable to afford their services. For example, some doulas offer payment plans or barter agreements. In other cases, families might qualify for insurance or health FSA reimbursements for doula services. Some expectant mothers request gift certificates or create registries whereby the doula is paid for via a baby shower fund. And depending on the region, hospitals and other organizations offer programs that make doula services more affordable. Research and clinical studies consistently demonstrate the benefits of doula support, which is why we believe it is imperative to maximize access to doula services, while still preserving the integrity of the profession."

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